About 80,000 children in the U.S. undergo appendectomies each year, making the procedure the most common emergency operation in kids. Still, in the 100 or so years the surgery has been performed, there has been little rigorous scientific research to guide its use. Now, a new study looks at two competing surgical approaches to treating the most dangerous form of appendicitis—when a child arrives at the emergency room with an appendix that has already ruptured, which happens about 30% of the time. For these patients, surgeons have been sharply divided for years on what course to take. Some doctors administer an antibiotic infusion followed by immediate surgery to remove the appendix. Others prefer initially to give antibiotics alone, and then wait six or more weeks to perform the appendectomy.